If you delve into the personal stories of health IT innovators, most journeys rest on their personal interaction with the health care system on behalf of themselves, a parent, a child, or perhaps a sibling. Just a few weeks ago, I had a small interaction with the health care system that confirmed many of the impressions I have developed of providers' strengths and weaknesses. There's no way to start except with ...

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shutterstock_225356470 While the electronic medical record (EMR) has advantages, it also has introduced liability risks. EMRs can lead to lawsuits or result in a weak defense by casting the physician in an unfavorable light. For example, examine these exchanges in a recent malpractice trial:

  • Plaintiff attorney: Doctor, if the emergency renal consult was called in at 11:30, why did you wait until 6 p.m. ...

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One of my patients got admitted this past week. As a new attending, this is still an unpleasant experience. Have I failed? Is there more I could have done to prevent this? I have to say that this particular case wasn't shocking. The patient hadn't been doing well lately, and I wasn't surprised when I got the message that they were on the way to the emergency room. Due to our ...

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On a 12-hour shift in the hospital, I recently spent a mere hour with patients, with the rest glued to a computer screen, to the "iPatient." When a patient comes to the hospital, speaking to them has become an afterthought to reading extensive medical records, physical exam findings from the emergency room, and synthesizing laboratory data. I, as a millennial doctor, have been on the cusp of this shift. My ...

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It is a heart pounding, head spinning, edge of your seat page-turner; the sort of rare saga that takes your breath away as it changes you, forever.  It hints at a radically different future, a completely new world a few years away, which will disrupt the lives of every man, woman, and child.  Available now, from the National Coordinator for Health Information Technology (ONC), Office of the Secretary, United States ...

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Doctors and hospitals often exist in a universe parallel to the consumers, patients, and caregivers they serve, a prominent chief medical information officer told me last week. In one world, clinicians and health care providers continue to implement the electronic health records systems they’ve adopted over the past several years, respond to financial incentives for meaningful use, and re-engineer workflows to manage the business of health care under constrained reimbursement. In ...

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A lot has been written about how awful electronic health record (EHR) systems are. They are overwrought, overengineered, dreadfully dull baroque systems with awkward user interfaces that look like they were designed in the early 1990s. They make it too easy to cut and paste data to meet billing level requirements, documenting patient care that never happened and creating multipage mega-notes, full of words signifying exactly nothing. They have multitudes of ...

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shutterstock_97947788 As I watch the business world's fascination with the electronic medical record (EMR) and all of the big data that it accumulates, I see more and more processes codified and treatment pathways carefully honed. Only one small thing remains until the computer can tell doctors how to behave based on the developed algorithms: To turn free text in the patient chart ...

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I once wrote about the communication difficulties caused by electronic medical records systems. The response on Twitter ranged from sentiments including everything from “right on, sister” to “greedy doctors are only complaining about EMRs because of their price tag.” The disconnect between policy wonk’s (and EMR vendor’s) belief in the transformative power of EMRs and exasperated clinician users of these products is jaw-dropping. Physicians are often labeled as ...

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shutterstock_196442450 A common complaint regarding the use of electronic medical records (EMRs) is that physicians spend the majority of their time with a patient “tinkering” on a computer rather than interacting with the patient. Use of EMRs is now mandatory in the U.S., creating many advantages: Patient information can be more easily shared in a secure environment, there are no lost files or ...

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